I love to read so during pregnancy, I signed up to a few baby sites. They sent information through weekly and I read it all. I like to be prepared. I felt prepared but still I have had many surprises that I am going to write about. Mostly so when my daughter asks me in 25 years’ time, I will have a reminder of those ‘whaaaat?’ moments.

The Pain: I already mentioned in previous blogs about birthing positions but it was such an eye-opener that I feel I must mention it here. First, I will acknowledge that pain is subjective and every woman experiences it differently. Having said that, the labour pain I felt was manageable despite being induced and on a syntocinon drip (which is meant to make it more painful). Until I made the mistake of lying flat on my back. Those minutes of being in that position where the most painful, second only to the post-birth examination. Upright was a million times better. Again, I’ll reiterate the hell the post-birth examination was. It was the single most painful part of giving birth and nothing to do with the baby. When the midwife had to examine me for tears/lacerations, it was all I could do not to scream the house down. After 8 hours of labour where I barely made a peep. Horrible. Steel yourself. Don’t be like me and mentally heave a sigh of relief once the baby is out. Hold it for that final examination to be over and pray you don’t need to have stitches.

Inability to make decisions: even before the exhaustion and sleep deprivation peaked, I struggled with making the simplest decisions. Specially to do with the baby. First, I couldn’t decide what the room temperature was. I’d spent most of pregnancy feeling like I had a very hot water bottle strapped to me. I simply couldn’t tell if the ambient temperature was just right or if it was cold but that suited my constantly hot self. And it was important as there was a little baby who couldn’t tell me how she felt and she didn’t have much fat to insulate her in those first few weeks. I also struggled to decide what to dress her in, what to eat and when to eat it and when it was best to ask my mama to have her for an hour so I could try to have a nap. It took roughly 3 months to reset my brain into first gear. I’m nearly back to full capacity 9 months later.

The sleeplessness: I thought I understood that a baby sleeps for short periods initially day and night but as time goes on, the intervals get longer and longer until you can manage some (few hours of) deep sleep. My baby never seemed to need much sleep. First two months, it was mostly 1-2 hours sleeps for her which means less for me as I was feeding, putting her to sleep then laying down and listening for too long if she was going to stay asleep. By the time I drifted off, she was beginning to surface so I was barely getting any quality restful sleep. Daytime was worse because whilst at night she would let me put her down, in the day time there was none of that (there still isn’t). She seems to have an internal sensor that is on in the day time. This sensor alerts her when she is asleep that she is being removed from human arms. As soon as her head touches down, her eyes spring open and all traces of sleep are gone. My mama was here for the first 6 weeks and she found a way to put her down for 1 nap a day. The idea was to give me the best chance of some sleep. Did I sleep? Not much. I would lie down and listen to even the minutest sound in the house. Eventually the exhaustion would come over me but usually I would have wasted an hour so that if I got 1 hour, I was lucky. By week 2, I felt like a zombie and that feeling didn’t leave until she was over 3 months old.

The guilt: every time she cries, I feel guilty as hell. I can’t seem to rationalise the fact that babies cry. You can do your best and do everything you can think of and then some and still, they cry. Even when I ignore her and carry on with my essential tasks, my heart feels so heavy with guilt hearing her cry. Even when I can see she is faking it (they learn these tricks way too early) and there are no tears, I feel this overwhelming guilt. I spent the first few months focusing all my energy on her and avoiding her cries. So much so that I would forget to eat, drink or have a wee until my body was desperate. A couple of months after my mama left, I had to have a word with myself. It was only after I reminded myself that a few tears wouldn’t harm her that I started to get on with everyday tasks. In the early days when I was trying to get her to sleep in her basket, it was tough. She would wake every hour and I was exhausted. Lots of people advised just letting her cry herself to sleep once I was satisfied she was fed, had a dry nappy and the room temperature was just right. I struggled on and on until I thought I had to try it. That night, I settled her down in the basket and lay in bed next to her. She was up within the hour so I didn’t pick her up. I let her cry. She cried and cried and cried some more. She was not stopping! I lay awake listening to her and after about 5 minutes, I started to cry myself. I rocked her basket but didn’t pick her up. I left her for as long as I could (probably 15-20 minutes) and the guilt nearly killed me. I didn’t try that again for a month. Again, she just continued to cry until I gave in.

The joy: so many little things that I always thought were cute in babies now bring me the most intense joy. When my daughter wakes up, searches for me and smiles the biggest happiest smile because I am there. When she reaches out her hand to touch my face as if to check I am real. When she laughs joyfully, as only children can. When she fakes a cough to get my attention. When she notices I am off-guard and pulls my glasses off with glee. When she grabs my sleeve/hip/belt as I walk past her highchair. When she splashes in the bath. When she comes back in from a walk with daddy and her face lights up on seeing me. My heart is always full to bursting with all the little joyous moments each day. And full of dread for when I must leave her and go back to work.

The pride: Every time she does something the first time…the first social smile, the first proper belly laugh, the first babbles, the first time she rolled over, the first time she sat up without support, the first time she crawled, the first time she pulled to stand. I watch her figure out how do something the first time, the intense concentration on her little face as she works it out. I watch to see the triumphant expression on her face when she succeeds. I watch the surprise on her face when she falls over or bumps into something and how hard she tries not to cry. I was so impressed that when she was immunised on 3 separate occasions, she cried for less than a minute each time. Same with when she got her ears pierced. I know I am biased but she is such a brave little girl. Her joy, her determination to learn new skills and her bravery make me such a proud mama.

Our journey together is at its very infancy so I am certain I will discover many more unknowns along the way. Suffice it to say, I am loving motherhood and I cannot wait to see what our tomorrows will bring. What fun!

It is 2 days before Christmas and everyone here is busy buying last minute gifts, wrapping them, decorating their personal spaces, starting Christmas lunch prep and all the other little things that make these holidays so great. I too am getting ready for a very special day and it is not Christmas. Sure I am looking forward to Christmas. I am going to spend the day with my husband in Oxford on Divinity Road no less with some of my dearest family. It will be wonderful I am sure but the day I am looking forward to comes later (hopefully much later!). I am expecting my first baby and my due date is 2nd of April 2016. Which means that as I am 6 months pregnant now, anything could happen. It could happen any day. Being a paediatrician, I am more aware than most of the unpredictability of pregnancy, going into labour and childbirth. I wake up every morning thanking God that my baby is still in there, safe and warm, their organs developing in the proper environment. I go to sleep praying that the baby remains in there for another couple of months at least.

Since I found out I was pregnant, I have been doing a lot of thinking and planning. As you do. First I have been thinking about time. Am I going to be ready for this? Many people have told me it will be the hardest, best, most satisfying, life-changing, painful and joyous thing to happen to me. I have always wanted to be a mother. I think even before I knew I wanted to be a doctor, I wanted a little girl of my own. I know I will love my child with everything I have and I know I have a lot of stamina (you can’t be a paediatrician and not have a lot of willpower and mental toughness). What I don’t know is will I be a great mother? Like my mother, will I be able to balance love and discipline, teach my child what is right and what is wrong and bring them up to be a decent human being? I pray for that the most. To be as good a mother to my child as mine was (and still is) to me. My mama is definitely a cut above the average mother. She was a single mum yet I never felt anything was lacking in my life. In fact when my sister and I reflect on not having a father, we both think that we have lost out on nothing and probably gained a lot from not having that side of the family to influence us. If our parents had stayed together, we would not have been nurtured in quite the same way. We would not have been encouraged to know and speak our minds in the same way. We would not have known that having a great mum is not just enough, it is the essential ingredient in a happy childhood.

I have tried hard not to think of all the potential complications that comes hand in hand with growing a baby and then delivering it. But I cannot escape the fact that this baby will one day be ready to come out and I will have to get it out (or at least give it my best shot). When I was studying obstetrics in medical school, a lot was said about the shape of pelvises and the birth canal. Particularly about which are favourable shapes (those with beautiful childbearing hips like my beautiful sister) and which ones are not – the android pelvis (damn you all!). I sat in the audience wishing that was a class I had skipped. So yes, I have an android pelvis (boyish in plain speak) so nature is not on my side when it comes to pushing this baby out. Thankfully, both my husband and I have small frames and the predicted size of my baby is small meaning I have a fighting chance. I will give it everything I can when the time comes to deliver the baby naturally. Fingers and toes crossed.

I have started setting up the nursery and not gone mad buying gadgets and fancy things all the moms tell me were never used. I look to my sister as inspiration. Before she became a mother the first time, she was a bit of a shopaholic. She would buy all sorts of useless things because they caught her eye in the spur of the moment. Then she fell pregnant and it seems overnight found self-control by the bucket-loads. She became super-organised and wrote list after list and budgeted. She stuck to her plans and her son had everything he needed but nothing was done to excess. Brilliant! I have made notes and I would like to be just like her. I have lists too and every time I tick something off, my little heart does a jig. I am on the way to being a mother.

Before I hit 24 weeks of pregnancy, I didn’t dare to dream about actually having the baby. That is because medically, I know that few babies born before 24 weeks of pregnancy survive and those who do survive, do so often with a lot of complications and a poor quality of life. I was terrified of having a baby who was more likely not to make it than make it. I did not want to think properly of baby names, of delivery, of breastfeeding, changing dirty nappies or being kept awake at night. Just in case this wasn’t meant to be. I know there are no guarantees in life and anything might happen yet but the longer my baby stays in closer to that due date, the more fighting chance we have of having a long happy healthy life together.

Lastly, I am ecstatic that I get to have a little person that I have (without putting much thought into it) been growing to love and cherish for the rest of my life. This baby is literally eating from my food, growing off the nutrients I have taken on board, sharing my blood, and getting oxygen from the oxygen I am breathing in. My baby is swimming around (I can feel the slow sliding rolling movements and the occasional sharper kicks as I write this) within my tommy, in a little sac of clear warm fluid. Maybe the baby is sucking their little fingers, blinking their eyes, practicing becoming a football player. It is the most amazing feeling to think that as I sit here this little person is being built in the incubator that was once the size of a satsuma which is now larger than a watermelon, shoving all my other abdominal organs out of the way to make more space for the baby. I cannot wait to meet my baby when they are ready to face the world. The one thing I do not worry about is that I will be at their side from the day they arrive until I am no more. I cannot wait for the beginning of the rest of my life.

One of the great privileges of being a paediatric doctor is the frontline seat we have on humanity. Of course we only see this great variety of human life and get to share in their stories because the NHS is still at the point of need free. We get to see how the very poor live their lives and also how the more affluent live theirs. Stereotypes abound within medicine and on the whole they ring true but we doctors and other frontline staff are constantly amazed and shocked by the unexpected. Life is certainly unpredictable as a doctor in the NHS. This is one of the reasons why I love the NHS so.

One of the greatest sorrows I have faced is when I come across a mother and or child who is being abused by the man who is supposed to love her and protect her from the rest of the world. One of our babies has been taken into foster care recently because the mother is being abused and has chosen that option for herself and her baby. I wanted to weep (still do) because I cannot imagine the horror that the mother has gone through and must be going through to carry a baby to term, labour to deliver her beautiful baby and then feel she must give that baby up. Heart breaking! In this case, the abuse is on-going and the father of the child not only threatened the mother with further abuse, he has threatened to kill the baby if she takes it home. Isn’t there something we can do for her I hear you ask? Of course there are ways in which we can help her. We have offered her every viable option including the one she has taken: giving up her child for fostering or adoption. She weighed up her options and came to a decision to give up the baby. Some of us are worried this is not a rational decision but unfortunately, within the law as she is an adult without any mental illness to cloud her judgement, we have to accept her decision whether it appears rational or wise or not.

Unfortunately, this case is not unique. In my 4 years of paediatrics, I have seen far too many cases of domestic violence and its many victims. 1 is too many but there have been dozens in my short time in the NHS. Bearing in mind that I have only worked in 7 NHS Hospitals and have seen but a tiny snippet of what is going on out there, this is a massive problem that is rarely talked about. Even within paediatrics and obstetrics where this is a major concern, we only talk about it when we get a case. Then it gets filed in the back of our minds until the next unfortunate case. Today I want to highlight the evil that is domestic violence and in my little way encourage anyone directly or indirectly affected to do something about it. What we need is more awareness and everyone who can do something to do a little bit so we can get some change happening.

As you may know, my mother is a feminist so I have always been aware of domestic violence in its many guises and how ugly it can get. As a young feminist, it was always one of those issues I was passionate about and I even wrote a radio drama aged 14 on the topic which got aired in Lagos in 2000. From a very early age, my mother taught me to have zero tolerance to domestic violence. I have always said that the minute a man raises his hand to hit me, unless it is in retaliation after I hit him first, that relationship is done and dusted. Some of you may think this is extreme but if you knew what I know, you would understand that zero tolerance is the best way to go about snuffing out domestic violence.

In medical school (here in Birmingham), I opted to do a module on Domestic Violence in my 4th year of study. It was a short module but the quality of teaching delivered voluntarily by the staff from the local Women’s Aid was fantastic. It was sobering to realise that the knowledge I had from what was happening in my hometown in Yola was mirrored in Britain. Britain may proclaim how forward thinking it is but just the same with Yola in Nigeria, their response to domestic violence is still inadequate and there is very little actual protection for the victims. Majority of the work is done by the voluntary sector trying to safeguard those who seek for help. By the very nature of this service provision, victims do not have access to help and unfortunately, many will continue to be victims until they end up in intensive care or even worse in early graves.

Domestic violence is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. It is not just physical violence. It can be verbal, sexual or neglect. It can be against a partner, a child or an older relative.

The vast majority of the victims of domestic violence are women and children, and women are also considerably more likely to experience repeated and severe forms of violence, and sexual abuse.

Women may experience domestic violence regardless of ethnicity, religion, class, age, sexuality, disability or lifestyle. Domestic violence can also occur in a range of relationships including heterosexual, gay, lesbian, bisexual and transgender relationships, and also within extended families.

The majority of abusers are men, but in other respects, they vary: abusers come from all walks of life, from any ethnic group, religion, class or neighbourhood, and of any age.

Abusers choose to behave violently to get what they want and gain control. Their behaviour may originate from a sense of entitlement which is often supported by sexist, racist, homophobic and other discriminatory attitudes.

The estimated total cost of domestic violence to society in monetary terms is £23 billion per annum. This figure includes an estimated £3.1 billion as the cost to the state and £1.3 billion as the cost to employers and human suffering cost of £17 billion.

The first incident of domestic violence occurred after one year or more for 51% of the women surveyed and between three months and one year for 30%.

Amongst a group of pregnant women attending primary care in East London, 15% reported violence during their pregnancy. Nearly 40% reported that violence started whilst they were pregnant, whilst 30% who reported violence during pregnancy also reported they had at some time suffered a miscarriage as a result (Coid, 2000).

The commonest question people who have not been victims ask is ‘why doesn’t she leave?’ To understand the answer, you have to try to understand how they become victims in the first place. The typical victim starts out as a happy vivacious young woman, often pretty with very social personalities. They meet and fall in love with a man who at first glance is perfect. Often these men are older, more experienced who charm the girl with their confidence and assertiveness. Once the young woman/girl is ‘in love’ and moves in with the abuser, he (often he but not always) will begin to isolate the girl from her friends and family. It often starts innocently but becomes more pervasive. Often the man will complain about some character flaw in one friend and systematically will find a way of making her cut ties with majority if not all of her social support network. He will often start with small acts of violence like physical restraint if she wants to go out and he doesn’t approve, seizing her shoes so cannot leave the house or calling her ugly when she dresses in a way that she would normally and in the way he would have previously approved. Then once he starts to isolate her, he will chip away at her confidence and withhold praise so that she begins to modify her behaviour to please him and to get approval. To please him, she often has to isolate herself from her friends and family and cater to his every whim. Despite that, he will find fault with all she does and he will start by criticising her. Eventually, he will physically punish her for not doing what she should. Mentally, because of the slow insidious way of grooming her into becoming a victim, she starts to believe that whenever he abuses her verbally or physically it is because she has failed to do something.

Eventually, she is truly a victim and she stops to see herself as a victim and him as an abuser. She begins to blame herself for everything that befalls her and see him as her saviour. Most will come to believe their abuse is an act of love. What it often takes for her to begin to see her thinking is faulty is either when she ends up in hospital because he has lost control and beaten her so badly that he ‘allows’ her to seek medical help or she has children or other family members she feels responsible for and they get harmed. Even then, these victims will often go back time and time again. Sadly, some will go back one too many time and end up dead. Or their child will end up dead or permanently damaged. Here are some statistics to back that fact:

Women are at greatest risk of homicide at the point of separation or after leaving a violent partner. (Lees, 2000)

60% of the women in one study left the abuser because they feared that they would be killed if they stayed. A further 54% of women left the abuser because they said that they could see that the abuse was affecting their children and 25% of the women said that they feared for their children’s lives. (Humphreys & Thiara, 2002).

The British Crime Survey found that, while for the majority of women leaving the violent partner stopped the violence, 37% said it did not. 18% of those that had left their partner were further victimised by stalkingand other forms of harassment. 7% who left said that the worst incident of domestic violence took place after they had stopped living with their partner. (Walby & Allen, 2004).

Lest I forget, I will mention the even more invisible group: male victims of domestic violence. I was heartened to see a poster the other day in a public toilet (female) offering male victims some help. This is just as important because we know that many perpetrators of (domestic) violence were once victims their selves. The man might be the victim in some cases. Learn to expect the unexpected.

So what do I suggest? For anyone who reads this, please share so that we can raise some awareness. If you suspect anyone you know might be a victim, please talk to them and point them towards the Women’s Aid website for help. Do not allow your friend or sister or mother to isolate herself. If you feel you are being pushed away and this is out of character for your friend, please persevere and remain friends with them even if it is only from a distance. Do not cut all ties as you may be tempted to do. Lastly, be watchful. Personally and for everyone you love. If you suspect something is amiss, draw them closer and be there so that if they need help, you might be that link that keeps them real and potentially saves their lives. If you are with a partner who is exhibiting some of the behaviours above, talk to someone you trust about it and ask for help. This help could come from Women’s Aid or even a trusted friend. If you are in a place where Women’s Aid or similar do not exist, turn to friends and family and seek for help early. No man is worth losing your dignity, sanity, health or life for.